Occupational therapy (therapeutic activities)
Facility: Labette Health
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $45
- Cash Discount Price: $103
- vs. Medicare Baseline: 1.28x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $35.07 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Uhccp | $21 | 60% |
| Healthy Blue | $29 | 83% |
| Medicaid / KanCare | $29 - $66 | 83% |
| Ambetter / Centene | $37 - $51 | 106% |
| UnitedHealthcare | $45 - $128 | 128% |
| Humana | $45 | 128% |
| Wellcare | $45 | 128% |
| Blue Cross Blue Shield | $45 - $57 | 128% |
| Montgomery County | $49 | 140% |
| Multiplan | $125 | 356% |
| Choicecare (First Health Network) | $133 | 379% |
| Health Partners Of Kansas, Inc | $133 | 379% |
Consumer Guidance & Cost Commentary
For the Occupational therapy (therapeutic activities) service at Labette Health in Parsons, KS, the cash price is $103.00, which is significantly lower than the facility's gross charge of $147.00. While the facility is a government-owned acute care hospital, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare plans in this network have negotiated rates ranging from $45.00 to $128.00, and Medicaid/KanCare plans range from $29.00 to $66.00. In cases where a patient has a high deductible or a plan with a high allowed amount, paying the cash price of $103.00 upfront could result in lower out-of-pocket costs compared to the insurance negotiated rate, provided the patient's deductible has not been met.
To minimize unexpected costs, patients should actively request "self-pay" or "prompt-pay" discounts before scheduling their visit, as these programs can offer substantial fee reductions for upfront payment. Additionally, it is crucial to review the itemized bill for errors, as over 80% of hospital bills contain mistakes such as double-billing or unbundled codes. When evaluating the facility's pricing against state standards, the cash price of $103.00 is notably higher than the state average of $35.07, though this comparison reflects the specific service code and facility type rather than a general hospital average. Ultimately, verifying the exact allowed amount with your specific insurance plan and requesting a waiver of insurance submission if paying cash is the most effective way to ensure you receive the best